Objective To evaluate the therapeutic effect of selective paraesophagogastric devascularization withoutsplenectomy in treatment of portal hypertension with upper gastrointestinal hemorrhage. Methods The clinical data of 27 patients who received selective paraesophagogastric devascularization without splenectomy from 2008 to 2011 were retrospectively analyzed. The hemogram， hepatic function， perioperative compliations， and free portal pressure （FPP） were observed. The patients were followed-up and the re-bleeding rate and survival rate were observed. Results The FPP decreased significantly（P＜0.05） after operation. The complication rate was 33.3%（9/27） after operation， including2 cases（7.4%） stress ulcer bleeding， 1 case （3.7%） acute bleeding portal hypertensive gastropathy， 1 case （3.7%） deep venous thrombosis， 1 case （3.7%） acute lung injury， 1 case （3.7%） death of hepatic encephalopathy， 3 cases（11.1%） new onset portal vein thrombosis. Twenty-four patients were followed up for an average of 27 months （8-57 months）. The overal survival rate was 92.6% （25/27）. Conclusion Selective paraesophagogastric devascularization without splenectomy is an effective method for treatment of portal hypertension with upper gastrointestinal hemorrhage.
ObjectiveTo investigate the feasibility and safety of spleen-preserving distal pancreatectomy (SpDP), and to discuss the indications and techniques of SpDP. MethodsThe clinical data of seven patients underwent SpDP between January 2004 and December 2007 in Xinhua Hospital were analyzed retrospectively. ResultsOut of the seven cases, one case received the SpDP combined with partial splenic vessel resection, while the other cases received the SpDP with splenic vessel preservation. The operation time was (2.93±0.38) h and the intraoperative blood loss was (392.86±109.65) ml. Only one case suffered from pancreatic fistula, who finally recovered after medicine therapy and percutaneous drainage. There was no other complication or operative mortality. The postoperative platelet count was (273±43.76)×109/L and the postoperative hospital stay was (17.86±8.07) d. For six cases of patients, no recurrence and metastasis was found after the followup (49.2±14.4) months （30-72 months）. ConclusionSpDP is a safe and feasible procedure, which is worthy for selected cases such as benign neoplasm of the body and tail of the pancreas.
ObjectiveTo study the indication and means in dissection lymph nodes of the No.10 and No.11 without splenectomy in radical gastrectomy for gastric cancer. MethodsAccording to the location, type of pathology, clinical and pathological classification, lymphatic drainage and spread of gastric carcinoma togather with the immunological function of spleen, selection of operative procedure without splenectomy should be considered, so the related literatures were reviewed. ResultsRetained spleen had been shown to improve 5year survival of patients with gastric cancer of stage Ⅰ,Ⅱ and Ⅲ,splenectomy had been shown to improve 5year survival of patients with gastric cancer of stage Ⅳ,whose carcinoma was infiltrating splenic and the lymph nodes of the No.10. The complications of different means of dissection of the lymph nodes made no difference.Conclusion Dissection of the lymph node without retained spleen or allogenic spleen transplantation is indicated for the patients with cancer of stage Ⅳ,whose spleen is invaded by the tumor.
Objective To probe into the significance of tuftsin in patients with liver cancer. MethodsThe serum tuftsin level of 12 patients with liver cancer before and after the resection，20 cirrhostic and 20 normal controls were measured by radioimmunoassay (RIA). ResultsTuftsin level in preoperative group （449±106） ng/ml was much lower than that in postoperative group (588±129) ng/ml，cirrhotics group (580±187) ng/ml and control group (703±128) ng/ml (P＜0.01). The tuftsin level in postoperative group was also quite lower than that in control group (P＜0.01). Conclusion We should try our best to excise the liver cancer so that a higher tuftsin level might be obtained which can activate NK cell and T cell.
Ｗｅ ｒｅｃｅｉｖｅｄ ａｎｄ ｔｒｅａｔｅｄ １８ ｃａｓｅｓ ｏｆ ｌｉｅｎａｌ ｈｙｄａｔｉｄｏｓｉｓ ｉｎ ｒｅｃｅｎｔ ｙｅａｒｓ．Ｆｉｆｔｅｅｎ ｐａｔｉｅｎｔｓ ｗｅｒｅ ｔｒｅａｔｅｄ ｓｕｒｇｉｃａｌｌｙ：７ ｃａｓｅｓ ｕｎｄｅｒｗｅｎｔ ｒｅｍｏｖａｌ ｏｆ ｅｎｄｏｃｙｓｔ ｆｏｌｌｏｗｉｎｇ ｔｈｅ ａｓｐｉｒａｔｉｏｎ ｏｆ ｃｙｓｔ ｆｌｕｉｄ ａｎｄ ｔｈｅ ｅｃｔｏｃｙｓｔｉｃ ｗａｌｌ ｏｐｅｎｅｄ ｏｒ ｆｉｌｌｅｄ ｗｉｔｈ ｇｒｅａｔｅｒ ｏｍｅｎｔｕｍ，２ ｃａｓｅｓ ｗｉｔｈ ｓｍａｌｌ ｃｙｓｔｓ，ｕｎｄｅｒｗｅｎｔ ｃｌｏｓｕｒｅ ｏｆ ｅｃｔｏｃｙｓｔ ｂｙ ｓｕｔｕｒｅ ｆｏｌｌｏｗｉｎｇ ｔｈｅ ｃｏｍｐｌｅｔｅ ｃｌｅａｎｉｎｇ ｏｆ ｔｈｅ ｒｅｓｉｄｕａｌ ｃａｖｉｔｙ，Ｏｎｅ ｃａｓｅ ｒｅｃｅｉｖｅｄ ｌａｐｒａｓｃｏｐｉｃ ｃｙｓｔｅｃｔｏｍｙ ａｎｄ ５ ｃａｓｅｓ ｕｎｄｅｒｗｅｎｔ ｃｏｍｐｌｅｔｅ ｒｅｓｅｃｔｉｏｎ ｏｆ ｔｈｅ ｓｐｌｅｅｎ．Ａｌｌ ｏｆ ｔｈｅ ｓｕｒｇｉｃａｌ ｃａｓｅｓ ａｔｔａｉｎｅｄ ｃｏｍｐｌｅｔｅ ｈｅａｌｉｎｇ．Ｉｎ ｔｈｉｓ ｐａｐｅｒ ｔｈｅ ｅｔｉｏｌｏｇｙ，ｄｉａｇｎｏｓｔｉｃ ｃｒｉｔｅｒｉａ ａｎｄ ｄｉｆｆｅｒｅｎｔｉａｌ ｄｉａｇｎｏｓｉｓ ａｎｄ ｔｈｅ ｉｍｐｒｏｖｅｄ ｍｅｔｈｏｄ ｏｆ ｓｕｒｇｉｃａｌ ｔｒｅａｔｍｅｎｔ ａｒｅ ｄｉｓｃｕｓｓｅｄ．
OBJECTIVE: To evaluate the histological characteristics of xenogeneic graft-versus-host disease (GVHD), and to differentiate it from the allogeneic GVHD. METHODS: The original articles related to the characteristics of xenogeneic GVHD and the relationship between xenogeneic GVHD and allogeneic GVHD were widely reviewed in the past decade. RESULTS: Xenogeneic GVHD was different from allogeneic GVHD in the speed of development, position and features of pathological changes, due to the incompatibility of common simulative signals, adhesive molecules and difference of antigens. Xenogeneic spleen transplantation could induce xenogeneic GVHD. CONCLUSION: Xenogeneic GVHD can be used as a model to mimic rejection in xenotransplantation and to evaluate the compatibility of xenotransplantation.
目的 探讨外伤性脾破裂非手术治疗的可行性、适应证及其治疗效果。 方法 回顾性分析我院1990年1月至2005年1月收治的外伤性脾破裂非手术治疗46例临床资料。结果 非手术治愈43例，3例因提前下床活动致大出血而中转手术，其中1例并发膈下脓肿，仍经保守治疗痊愈。无死亡病例。结论 在严格掌握适应证前提下非手术治疗外伤性脾破裂安全可行，年龄及腹腔外合并伤不是影响非手术治疗的主要因素。